Kang Tianlun, Xi Yajing, Liu Xiaoping, Qian Tangliang, Lu Siyi, Li Leqing, Liu Zhi, Wei James Cheng-Chung, Hou Xiujuan
Department of Rheumatism, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
Department of Traditional Chinese Medicine, Fu Xing Hospital, Capital Medical University, Beijing, China.
Front Immunol. 2025 Jul 8;16:1624223. doi: 10.3389/fimmu.2025.1624223. eCollection 2025.
To compare the risk of chronic obstructive pulmonary disease (COPD) between patients newly diagnosed with RA and individuals without RA. This large-scale study aims to provide novel insights into the association between RA and COPD by evaluating the impact of clinical factors and medications on COPD risk, using robust propensity-score matching.
This retrospective comparative cohort study utilized data from the TriNetX Research Network, collected on October 9, 2023. Patients newly diagnosed with RA from 2010 to 2021 were compared to non-RA individuals matched on demographics and medical history. Propensity-score matching balanced baseline covariates. The primary outcome was the 5-year risk of newly onset COPD (ICD-10: J41-J44), analyzed using Kaplan-Meier and Cox's proportional hazards models.
The study included 136,820 pairs of RA and non-RA patients. The 5-year cumulative probability of COPD was 7.36% in the RA cohort versus 5.97% in the non-RA cohort, with a hazard ratio of 1.228 (95% CI = 1.186-1.272). Subgroup analyses showed higher COPD risk in RA patients across different demographics and clinical factors. Males, older patients, higher rheumatoid factor, and higher erythrocyte sedimentation rate increased COPD risk, while DMARDs and systemic NSAIDs reduced it.
RA patients have a significantly higher risk of developing COPD compared to non-RA individuals. These findings underscore the importance of targeted COPD prevention and management in RA patients.
比较新诊断为类风湿关节炎（RA）的患者与无RA个体患慢性阻塞性肺疾病（COPD）的风险。这项大规模研究旨在通过使用稳健的倾向评分匹配法评估临床因素和药物对COPD风险的影响，从而为RA与COPD之间的关联提供新的见解。
这项回顾性比较队列研究利用了TriNetX研究网络于2023年10月9日收集的数据。将2010年至2021年新诊断为RA的患者与在人口统计学和病史方面匹配的非RA个体进行比较。倾向评分匹配平衡了基线协变量。主要结局是新发COPD的5年风险（国际疾病分类第十版：J41-J44），使用Kaplan-Meier法和Cox比例风险模型进行分析。
该研究纳入了136,820对RA和非RA患者。RA队列中COPD的5年累积概率为7.36%，而非RA队列中为5.97%，风险比为1.228（95%置信区间 = 1.186-1.272）。亚组分析显示，在不同人口统计学和临床因素的RA患者中，COPD风险更高。男性、老年患者、类风湿因子升高和红细胞沉降率升高会增加COPD风险。
与非RA个体相比，RA患者患COPD的风险显著更高。这些发现强调了对RA患者进行针对性COPD预防和管理的重要性。
